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Reminder of important clinical lesson
Acute ischaemic ventricular inferoseptal defect in a pyretic patient: a diagnostic challenge
  1. Martina Muscat,
  2. Etienne Laverse,
  3. Zaka Haq,
  4. Anwar Ahmad Chahal,
  5. Javed Akhtar
  1. Cardiology Department, Queens Hospital, London, UK
  1. Correspondence to Dr Etienne Laverse, etienne.laverse{at}


A 78-year-old Caucasian male presented with a 5-day progressive history of fever, vomiting and dyspnoea. Initial clinical examination revealed fever, sinus tachycardia, hypotension, peripheral cyanosis and a systolic murmur. Investigations revealed a multiple organ dysfunction syndrome. A repeat trans-thoracic echocardiogram showed a basal inferoseptum aneurysm associated with an acquired ventricular septal defect not demonstrated on initial scan. An intra-aortic balloon pump was urgently inserted and he underwent surgical repair of the defect, 7 days after his initial presentation. He unfortunately died from postoperative complications.

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  • Competing interests None.

  • Patient consent Obtained.